结肠病变组织PGE2测定及阿司匹林对结肠腺瘤和结肠癌术后复发的影响

目的探讨溃疡性结肠炎、结肠腺瘤和结肠癌病变组织中前列腺素E2（PGE2）含量的变化,以及阿司匹林对结肠腺瘤和结肠癌术后复发的影响。方法采用放免法测定溃疡性结肠炎、结肠腺瘤和结肠癌病变组织匀浆中PGE2含量。将结肠腺瘤及结肠癌术后病人分为阿司匹林治疗组及谷维素对照组,随访6个月,观察2组复发率。结果术前溃疡性结肠炎、结肠腺瘤及结肠癌病变组织中的PGE2含量分别为（143.40±18.32）（、184.52±21.21）、（242.43±23.40）ng/g,三者差异有统计学意义（F=278.52,q=13.79～33.22,P〈0.05）。术后6个月,阿司匹林治疗组复发率与谷维素对照组比较,差异有统计学意义（χ^2=5.38,P〈0.05）。结论结肠癌组织中PGE2含量呈明显升高趋势。阿司匹林有一定预防结肠腺瘤及结肠癌术后复发的作用。     

小檗碱对非甾体消炎药相关性肠损伤的保护作用及其机制研究

背景：近年非甾体消炎药（NSAIDs）相关性肠损伤的发生率明显升高,但目前尚缺乏有效防治NSAIDs相关性肠损伤的药物。目的：研究中药小檗碱对NSAIDs相关性肠损伤的治疗作用及其机制。方法：将40只大鼠随机分为对照组、模型组以及低、中、高剂量小檗碱干预组（分别为25、50、75mg·kg-1·d-1）。采用7.5mg·kg-1·d-1双氯芬酸制备NSAIDs相关性肠损伤模型。造模第5d处死所有大鼠,行小肠黏膜大体、组织学评分。以ELISA法检测小肠黏膜前列腺素（PG）E2含量,硝酸还原酶法检测小肠黏膜和血清NO含量,免疫组化法检测小肠黏膜环氧合酶（COX）-1、COX-2表达。结果：与对照组相比,模型组大鼠小肠大体评分和组织学评分明显升高（P〈0．05）,小肠黏膜PGE,含量明显降低（P〈0．05）,小肠黏膜和血清NO含量明显升高（P〈0．05）,小肠黏膜COX-1表达明显降低（P〈0．05）,COX-2表达明显升高（P〈0．05）。给予低、中、高剂量小檗碱干预后,上述指标明显改善（P〈0．05）。结论：小檗碱对NSAIDs相关性肠损伤具有保护作用,其机制可能与小檗碱致小肠黏膜PGE：、COX-1表达升高以及组织和血清NO含量、COX-2表达降低有关。     

Comparing two dinoprostone agents for cervical ripening and induction of labor: a randomized trial

OBJECTIVE: To compare dinoprostone gel and insert in achieving successful vaginal delivery in nulliparous and multiparous women. STUDY DESIGN: 220 nulliparous and 100 multiparous with a Bishop score < or =7 were randomized to receive dinoprostone either gel or insert for cervical ripening. The main outcome measures were the rate and latency of vaginal delivery. RESULTS: In nulliparous women no significant differences were found between the gel and insert groups in the rate of vaginal delivery (85.6% vs. 80.7%) delivery < or =12 (36.8% vs. 32.9%) and < or =24h (85.3% vs. 93.4%) regardless of the preinduction Bishop score. Nulliparous with Bishop score < or =4 treated with the insert had a decreased risk (p<0.05) of post partum hemorrhage (4.8%) when compared with nulliparous treated with gel (16.7%). On the contrary, in multiparous the time to delivery interval was significantly shorter in the gel treated group (9.9+/-4.9h vs. 13.1+/-5h; p<0.001) with more patients delivering vaginally < or =12h (75% vs. 37.5%, p<0.001), regardless of the preinduction Bishop score. CONCLUSION: Both dinoprostone gel and insert are efficient in achieving cervical ripening and successful labor in nulliparous and multiparous. In multiparous, however, the gel significantly reduces the time to vaginal delivery with more patients delivering vaginally < or =12h, regardless of the Bishop score.     

欣普贝生应用于妊娠晚期引产的临床疗效观察与护理

目的探讨欣普贝生应用于妊娠晚期引产的临床疗效及护理方法。方法将90例妊娠晚期有引产指征的孕妇分为观察组和对照组,对照组采用缩宫素引产,观察组采用欣普贝生引产．用药期间加强护理．比较两组产妇的引产结果。结果两组产后出血、新生儿结局无显著性差异（P〉0．05）。观察组的宫颈成熟评分显著高于对照组,引产成功的例数显著多于对照组,临床时间显著短于对照组（P〈0．05）。观察组的剖宫产率显著低于对照组（P〈0．05）。两组产后出血、新生儿结局比较差异无统计学意义（P〉0．05）。结论欣普贝生应用于妊娠晚期引产效果满意,可提高引产成功率。降低剖宫产率。     

普贝生用于足月妊娠引产的疗效观察

目的：研究普贝生用于足月妊娠引产的疗效。方法：80例孕38～42周、单胎无妊娠合并症的初产妇为观察组．阴道放置普贝生引产,70例初产妇为缩宫素组。比较两组产妇的宫颈Bishop评分、剖宫产率、产后出血量等。结果：观察组给药后的宫颈Bishop评分明显提高,两组比较差异有高度统计学意义（P〈0．01）。观察组剖宫产率小于缩宫素组（P〈0．05）。两组产妇产程中的胎心变化、羊水异常发生率和产后出血量无显著性差异（P〉0．05）：两组新生儿出生时状况无明显差异（P〉0．05）。结论：普贝生可安全、有效地刚于足月引产。     

普贝生应用于足月胎膜早破计划分娩

目的:探讨地诺前列酮(普贝生)用于足月胎膜早破患者计划分娩的有效性及安全性。方法:选取计划分娩的单胎初产妇140例,均有计划分娩指征,分为实验组(胎膜早破组)59例、对照组(胎膜未破组)81例。观察用药前后宫颈Bishop评分,用药至临产及分娩的时间、用药24 h阴道分娩率,改用缩宫素使用率,手术产率,新生儿Apgar评分及有无不良反应,产后24 h出血量、产褥感染情况。结果:两组的宫颈Bishop评分、用药后至出现规律宫缩,总产程,产后出血,产褥病率及Apgar评分,新生儿窒息率差异均无统计学意义。结论:普贝生用于足月胎膜早破者计划分娩是有效和安全的,对临床有着重要的指导意义。     

地诺前列酮促胎膜早破孕妇宫颈成熟的临床研究

目的:评价欣普贝生(地诺前列酮)对胎膜早破足月孕妇引产的有效性和安全性.方法:选取计划分娩的单胎初产妇200例,随机分为实验组(欣普贝生治疗组)100例和对照组(缩宫素治疗组)100例.比较两组宫颈Bishop评分、用药效果、新生儿结局及不良反应.结果:实验组与对照组用药前后宫颈Bishop评分差值分别为(6.59±1.68)分与(4.92±1.71)分,差异有统计学意义(t=6.963,P＜0.001);实验组阴道分娩率(87.00％)高于对照组(71.00％)(x2=7.715,P=0.005);两组总产程、羊水浑浊率差异均有统计学意义(P＜0.05);而两组出血量比较差异无统计学意义(P =0.169).欣普贝生和缩宫素临床使用均无严重不良反应.结论:欣普贝生(地诺前列酮)是一种有效的促宫颈成熟和引产药物,使用方便、安全可靠、适用于胎膜早破足月引产.     

Reducing blood loss at abdominal myomectomy with preoperative use of dinoprostone intravaginal suppository: a randomized placebo-controlled pilot study

Objective

To determine the effect of a single preoperative intravaginal prostaglandin E₂ (PGE₂; dinoprostone) suppository on reducing intraoperative blood loss and the need for subsequent blood transfusion at abdominal myomectomy for symptomatic leiomyomas.

Study design

In a prospective randomized double-blind placebo-controlled pilot study, 108 women who had abdominal myomectomy for symptomatic leiomyomas were enrolled. Patients were randomly assigned to receive a single dose of intravaginal 20 mg dinoprostone (n = 54) or placebo (n = 54) 60 min before the operation. The primary outcome was the operative blood loss. The secondary outcomes were the need for blood transfusion, change in hemoglobin (Hb) level 24 h after operation, and the prevalence of side effects.

Results

Blood loss and transfusion rate were significantly greater in the group without PGE₂ suppository (group B) than in the group with PGE₂ (group A): they were respectively 485.7 ± 361.3 mL vs 364.1 ± 279.4 mL (P = .02; relative risk [RR] 0.95; 95% confidence interval [CI], 0.63–1.45) and 18.5% vs 3.7% (P = .04; RR 1.32; 95% CI, 3.7–18.5). Group B had a significant decrease in Hb level 24 h after operation compared with group A (P < .05). There was no difference in the patient demographics, intraoperative characteristics, postoperative stay, complications, and the side effects between the two groups.

Conclusion

A single pre-operative dose of dinoprostone administered intravaginally could be a safe and reliable method to help decrease blood loss during abdominal myomectomy. Further larger prospective studies are required to support this conclusion.     

欣普贝生联合哌替啶对孕足月促宫颈成熟的临床观察

目的观察欣普贝生联合哌替啶对孕足月促宫颈成熟中的作用。方法选择孕足月需要促宫颈成熟符合欣普贝生使用原则的病例,随机分为三组分别为欣普贝生组、缩宫素组、欣普贝生联合哌替啶组。观察用药前后宫颈Bishop评分、分娩方式、24小时内阴道分娩情况。结果促宫颈成熟情况、分娩方式和24小时内阴道分娩情况缩宫素组明显差于其余两组,均存在非常显著性差异(P<0.01)。A组和C组之间:24小时内阴道分娩情况亦均有非常显著性差异(P<0.01),促宫颈成熟情况有显著性差异(P<0.05),在分娩方式比较,无显著性差异(P>0.05)。结论欣普贝生联合使用哌替啶可以缩短产程,比单用欣普贝生效果好。     

普贝生用于足月引产的疗效研究

目的观察普贝生用于足月妊娠引产的临床效果。方法随机将具备引产指针的孕足月单胎头位孕妇分为2组,普贝生组和催产素组,各60例,比较用药前后2组孕妇的宫颈Bishop评分情况、引产的成功率及剖宫产率。结果2组药物均显著促宫颈成熟,观察用药6h、12h宫颈评分显著提高,研究组效果更明显,相比较差异有统计学意义（P〈0.05）,研究组引产成功率为93.3%,对照组引产成功率为53.3%,2组引产成功率相比差异均有统计学意义（P〈0.05）;研究组剖宫产率26.7%,对照组为65%,2组比较差异有显著性（P〈0.05）。结论普贝生是一种安全有效的促宫颈成熟及引产的药物,可降低剖宫产率。